2018 Medicaid Managed Care Summit
Strategies to Serve the Rapidly Expanding Medicaid Population
September 27-28, 2018 * Omni Shoreham Hotel * Washington, DC

2018 Medicaid Managed Care Summit








About the Conference

Medicaid is the single largest source of health coverage in the U.S. Now more than ever before, states are relying heavily on managed care organizations to serve their Medicaid beneficiaries to improve the quality of care delivered and control costs. Bringing together Medicaid leaders from states and health plans, as well as government leaders and policymakers, this summit will address the most pressing issues facing state Medicaid managed care. You will learn about national trends and innovative programs to best serve the growing Medicaid population; current federal and state policies and regulations; strategies to better manage utilization of health services; social determinants of health to better serve members; improvements in healthcare quality and outcomes; how to best coordinate care for complex populations; coordinating and integrating LTSS in managed care plans; how to achieve value-based care; and much more.

Who Should Attend?

From State & Government Agencies:

Directors and Managers of:

  • State Medicaid
  • Managed Care
  • Health Services/Healthcare Programs
  • Human/Social Services
  • Medical Assistance
  • Strategic Planning
  • Policy Analysis
  • Compliance
  • Quality Assurance
  • Quality Improvement
  • Healthcare Financing

From Health Plans & Managed Care Organizations:

Directors and Managers of:

Chief Executive Officers, Chief Operating Officers, Chief Financial Officers, Chief Medical Officers, Chief Strategy Officers, and Chief Information Officers
Also, Presidents, Vice Presidents, Directors and Managers of:

  • Medicaid
  • Long-Term Care
  • Behavioral Health
  • Sales and Marketing
  • Network Development
  • Compliance
  • Clinical Affairs
  • Finance
  • Operations

This Program is Also Relevant to:
Organizations Providing Services for:

Care Management Technology * Care Management for the Elderly * Pharmacy Benefit Administrators * Health Management Solutions * Behavioral Health Services * Revenue Enhancement Services * Reinsurance Services

Conference Agenda

Day One – Thursday, September 27, 2018

7:15am – 8:00am
Registration & Networking Breakfast

8:00am – 8:15am
Chairperson’s Opening Remarks

8:15am – 9:00am
Keynote: The Future of the Healthcare Landscape and Medicaid
There is a lot of uncertainty surrounding what the future of healthcare will look like – in particular, Medicaid. This session will present an overview of the current healthcare and Medicaid landscape, important considerations and what to expect in the future, what you should be focusing on, and how potential changes might affect your operations and strategy. Learn about regulations that are likely to impact the Medicaid managed care market over the next few years, as well as topics such as:
- Implications to state budgets and what this means for the Medicaid population
- How to adjust your strategy to meet the goals of current as well as upcoming implementation requirements and dates
- Compliance challenges and efforts to increase transparency and accountability
- Implications to managed care organizations and state contracts and relationships
- Funding challenges and policy priorities

9:00am – 9:45am
Building a Culture of Engagement for Medicaid Managed Care Members
This session will address strategies for effective Medicaid managed care member engagement. Topics to be discussed will include:
- Engaging members through advocacy and outreach programs
- Connecting members to resources and helping them navigate the healthcare system
- The case managers role in member engagement
- Incentives that drive high-value behaviors and more personalized connections
- Early engagement strategies
- Developing a member-centric, collaborative approach to care management
- Health needs assessments
- Shared decision-making models

9:45am – 10:15am
Networking & Refreshments Break

10:15am – 11:00am

11:00am – 11:45am
Collaboration with Providers: Working Together to Improve Outcomes
This session will address best practices for working with providers to better address their needs with the goal of improving network adequacy. Topics to be discussed will include:
- Data sharing, transparency and reporting
- Aligning incentives
- Overcoming barriers to care coordination and performance
- Achieving reimbursement targets
- Improving quality of care
- Establishing outcomes and quality measures

11:45am – 1:00pm

1:00pm – 1:45pm
Solutions to Tackle Opioid Misuse and Addiction and Ensuring Access to Effective Treatment
In this session learn what states are doing to prevent opioid misuse and addiction and improve the quality of care for the Medicaid managed care population. Topics to be discussed will include:
- Measures to curb overprescribing
- Improving access to quality treatment programs
- Challenges associated with the development of enhanced opioid treatments
- The impact on state budgets
- Strategies for partnering with outside agencies to help members remain engaged in treatment

1:45pm – 2:30pm
Medicaid Managed Care Quality Ratings
This session will discuss how states are implementing quality ratings systems for plans, enabling themselves to better managed and measure the quality of care provided by Medicaid managed care plans. This session will examine how states can leverage these ratings to:
- Set goals
- Increase transparency and oversight
- Assist in contracting with managed care plans
- Address health disparities
- Identify beneficiaries who require LTSS or have other special healthcare needs

2:30pm – 3:00pm
Networking & Refreshments Break

3:00pm – 4:15pm
Panel: State Approaches to Medicaid Expansion
This panel will examine what states are doing to expand Medicaid to beneficiaries who are newly eligible for the program. Topics to be discussed will include:
- Education and outreach efforts
- Delivery system reform
- Capacity needs
- Benefit design and development

4:15pm – 5:00pm
A Population Health Management Approach to Reaching Member with Complex Needs
The Medicaid managed care population is very diverse, made up of members with different needs, behaviors and backgrounds. This session will address how to move to a population health management approach to better serve the needs of your member. In this session, you will learn how to recognize the key elements to manage a diverse Medicaid population, as well as topics such as:
- Removing barriers to care
- Coordinate services across multiple populations and demographics
- Improving utilization while maintaining a strong financial position
- Learning what drives member behavior and better understand member patterns

End of Day One

Day Two – Friday, September 28, 2018

7:15am – 8:00am
Networking Breakfast

8:00am – 8:15am
Chairperson’s Remarks

8:15am – 9:00am
Innovations, Trends and Best Practices in Medicaid Managed Care
Learn about what states are doing that are likely to develop into national trends, and how you can best position your organization for success. Topics to be discussed will include:
- Strategies to improve quality, manage cost and drive innovation
- Implementing effective programs to impact high utilizers of Medicaid services
- How to better meet the needs of the Medicare population
- Flexible benefit design and new funding models
- Medicaid waivers
- How to best serve special needs populations with complex conditions

9:00am - 9:45am
Implementing a Strategy to Address Social Determinants of Health
This session will discuss how to best address social determinants of health through Medicaid managed care. Topics to be addressed will include:
- Identify social determinants that fall within the scope of managed care
- Assessment tools
- Impact on ED utilization and hospital admissions and readmissions
- Leveraging data as a complement to claims data for risk adjustment and identification

9:45am – 10:30am
Value-Based Payments in Medicaid Managed Care
States are increasingly looking to move away from volume-driven fee-for-service payments and
toward value-based payment arrangements. This session will explore state options for using
managed care contracts to accelerate value-based payment arrangements. Topics to be discussed will include:
- Establishing quality metrics
- Baselines for patient outcomes
- Determining parameters for “improved health”

10:30am - 11:00am
Networking & Refreshments Break

11:00am – 11:45pm
Integrating Care Beyond Traditional Managed Care
States are implementing a range of initiatives to coordinate and integrate care beyond traditional managed care. This session will address lessons learned from these models, including:
- Integrating MLTSS, acute care, behavioral health, medical and pharmacy services
- How integration can improve quality and reduce costs
- Improving care for populations with chronic and complex conditions
- Aligning payment incentives with performance goals
- Building in accountability

11:45am – 12:30pm
Utilizing Community-Based Organizations to Meet the Needs of Your Medicaid Managed Care Population
This session will address the importance of engaging partners and community-based organizations to create a patient-centered and community-based approach to care. Topics to be discussed will include:
- Leveraging your community to meet the needs of members and improve care coordination, access and delivery
- Facilitating clinical-community linkages for members
- Utilizing health informatics tools to facilitate referrals between healthcare and non-healthcare entities
- Engaging community-based service providers in MLTSS
- Community-based health and wellness centers

Conference Concludes

Workshop – Friday, September 28, 2018

12:45pm – 2:45pm
Strategies to Prevent Fraud, Waste and Abuse: How to Maintain the Integrity of Your Program
This workshop will address ways to prevent fraud, waste and abuse, including:
- Mechanisms to identify, investigate, and refer suspected fraud and abuse cases to appropriate state and federal law enforcement and cooperate with federal program integrity initiatives
- Conducting program integrity activities and making sure MCOs maintain effective program integrity programs of their own
- Conducting audits of the accuracy, truthfulness and completeness of the encounter and financial data
- Screening and disclosure reviews
- Ensuring that MCOs disclose certain information
- Ensuring that all network providers are enrolled with the state as Medicaid providers consistent with the provider disclosure, screening and enrollment requirements
- Compliance requirements that ensure transparency and accountability
- Reviewing and analyzing encounter data to guard against underutilization
- Developing mechanisms for appropriate payments such as ensuring that capitation rates are correct and actuarially sound

Featured Speakers

Jeffrey T. King, RN, MBA

Jeffrey T. King, RN, MBA

Vice President Healthcare Services

Molina Healthcare of Florida

Jill Hunter

Jill Hunter

Deputy Commissioner

Kentucky Cabinet for Health and Family Services

Kristi Putnam

Kristi Putnam

Program Manager, Kentucky HEALTH Team

Kentucky Cabinet for Health and Family Services

John C. Stancil, Jr. RPh

John C. Stancil, Jr. RPh

Director of Pharmacy, DMEPOS, Home Care and Ancillary Services, Division of Medical Assistance

North Carolina Department of Health and Human Services

Chad Corbett, MPA, HS-BCP

Chad Corbett, MPA, HS-BCP

Vice President, Long Term Care

Mercy Care Plan

Sue Birch

Sue Birch


Washington State Health Care Authority

Patricia D. Byrnes

Patricia D. Byrnes

Director – Federal Affairs, Government and External Affairs

AmeriHealth Caritas Family of Companies

Elizabeth Matney

Elizabeth Matney

Bureau Chief, Medicaid Managed Care

Iowa Department of Human Services

Jeanne James, MD

Jeanne James, MD

Vice President and Chief Medical Officer

BlueCross BlueShield of Tennessee

Frances Martini, RN, BSN, MBA

Frances Martini, RN, BSN, MBA

Population Health Vice President

BlueCross BlueShield of Tennessee

Stephani Ryan

Stephani Ryan

Vice President – LTSS Programs

BlueCross BlueShield of Tennessee


Omni Shoreham Hotel
2500 Calvert Street NW
Washington, DC 20008

Mention BRI Network to get the discounted rate of $209/night

Sponsors and Exhibitors

Media Partner

Managed Care delivers high-interest articles and features developed through original research and writing. Its editorial mission is to advise managed markets physicians, pharmacists, and executives on the integration of the business and medical aspects of the rapidly changing managed care market. A strict fact-checking and peer-review process assures the accuracy and relevance of editorial content.


Are there group discounts available?

  • Yes – Register a group of 3 or more at the same time and receive an additional 10% off the registration fee

Are there discounts for Non-Profit/Government Organizations?

  • Yes – please call us at 800-743-8490 for special pricing

What is the cancellation policy?

  • Cancellations received 3 weeks prior to the event will receive a refund minus the administration fee of $185. Cancellation received less than 3 weeks prior to the event will receive a credit to a future event valid for one year.

Can the registration be transferred to a colleague?

  • Yes – please email us in writing at info@brinetwork.com with the colleague’s name and title

Where can I find information on the venue/accommodations?

  • Along with your registration receipt you will receive information on how to make your hotel reservations. You can also visit individual event page for specific hotel information. The conference fee does not include the cost of accommodations.

What is the suggested dress code?

  • Business casual. Meeting rooms can sometimes be cold so we recommend a sweater or light jacket
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